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Results for “Developmental Disabilities”

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PubMed2005

Environmental toxicants and developmental disabilities: a challenge for psychologists.

Developmental, learning, and behavioral disabilities are a significant public health problem. Environmental chemicals can interfere with brain development during critical periods, thereby impacting sensory, motor, and cognitive function. Because regulation in the United States is based on limited testing protocols and essentially requires proof of harm rather than proof of lack of harm, some undefined fraction of these disabilities may reflect adverse impacts of this "vast toxicological experiment" (H. L. Needleman, as quoted in B. Weiss & P. J. Landrigan, 2000, p. 373). Yet the hazards of environmental pollutants are inherently preventable. Psychologists can help prevent developmental disabilities by mobilizing and affecting public policy, educating and informing consumers, contributing to interdisciplinary research efforts, and taking action within their own homes and communities to reduce the toxic threat to children.

Brain↗

PubMed2001

Foreign body ingestion in children with severe developmental disabilities: a case study.

Dysphagia is common in children with severe developmental disabilities. The nature of these difficulties can predispose them to foreign body ingestion. This article presents a case that highlights the need for vigilance in diagnosing dysphagia in children with multiple and complex developmental disabilities where severe cognitive impairment and an inability to communicate may mask the presence of underlying problems.

Barium Sulfate↗

PubMed1998

Benefits of early intervention for children with developmental disabilities.

Early intervention programs are designed to enhance the developmental competence of participants and to prevent or minimize developmental delays. Children targeted for early intervention may either include environmentally or biologically vulnerable children, or those with established developmental deficits. There is growing consensus based on the best available evidence that early interventions can exert moderate positive effects. However, this literature is limited by substantial methodological weaknesses in most studies. Therefore further randomized clinical trials are needed to ascertain which programs best meet the needs of children with or at risk for developmental disability.

Child, Preschool↗

PubMedDate not supplied

Use of directed history and behavioral indicators in the assessment of the child with a developmental disability.

It can be very difficult to get a complete history and review of systems for children with developmental disabilities and poor communication skills. In addition, many children with developmental disabilities may engage in self-injurious or aggressive behavior. Although the causes of inappropriate behavior are frequently environmental, physiologic components may exist as well, particularly pain or discomfort. History taking must be focused and specific and may need to focus on the child's behavioral patterns, because the child may not have sufficient communication skills to describe his or her problem and parents or guardians may not realize the relevance of certain behaviors. Gastrointestinal problems in particular may be a source of discomfort and should be reviewed with particular care. Referral to a psychologist who is able to perform a functional analysis of behavior may be necessary to treat problem behavior, especially if medical causes have been ruled out.

Adolescent↗

PubMed2001

Risk factors for injuries and falls among adults with developmental disabilities.

The present study was designed to identify risk factors for injuries including falls and non fall-related injuries among adults with developmental disabilities. The following variables were examined as potential risk factors: age, gender, level of intellectual disability, health, seizures, ambulatory status, adaptive and maladaptive behaviours, use of antipsychotic drugs, and type of residential setting. The subjects were 268 adults with developmental disabilities > or = 30 years of age. A total of 30 participants (11%) were reported to have injuries. Over 50% of injuries were caused by falls. Individuals who had a higher frequency of seizures, had more destructive behaviour and used antipsychotic drugs had the highest risk of injuries. A sub-analysis of fall-related injuries indicated that individuals who were > or = 70 years of age, ambulatory and had a higher frequency of seizures had the highest risk of injurious falls. Adaptive behaviour, destructive behaviour and physical health were positively related to non-fall-related injuries. Individuals with developmental disabilities who have better health and greater adaptive behaviour may be more active, and therefore, at an increased risk of non-fall-related injuries.

Accidental Falls↗

PubMed2002

[Social welfare for children with developmental disabilities in the 21st century].

For children with developmental disabilities in Japan, various social policies including education, medical care, pension and welfare have rapidly developed and prevailed during the last 50 years. The concept of living together with the disabled has been widely accepted. A high standard of social welfare has been established by virtue of high respect for human rights, progress in medicine and economic growth. Historically, the International Year for the Disabled played an important role in meeting the expectation of the disabled and their families. Amendment of the legal system has realized normalization and social independence. Based on this historical background, there are in the 21st century new trends of development in the education, welfare and social life of the disabled, aiming at a better society for all the people.

Child↗

PubMed2004

Prevalence of low bone-mineral density among mentally retarded and developmentally disabled residents in intermediate care.

OBJECTIVE: To explore the prevalence of low bone-mineral density (BMD) and related fractures among mentally retarded and developmentally disabled residents in intermediate care settings. DESIGN: Cross-sectional study. SETTING: Intermediate care facilities for mentally retarded and developmentally disabled (< 16 beds) and group homes (> or = 16 beds) in the mid-western United States. PARTICIPANTS: A total of 360 residents were selected for the initial study group; 119 were excluded, 241 remained to study completion. INTERVENTION: Antiresorptive therapy with alendronate 10 mg daily and calcium 500 mg with vitamin D 200 IU, three times daily, for participants in the osteoporosis range; calcium 500 mg with vitamin D 200 IU three times daily for participants in the osteopenia range. MAIN OUTCOME MEASURES: Low BMD and related fractures. Secondary measures included medications associated with bone loss, mobility level, medical diagnoses associated with bone loss, diagnosis of bone disorders, level of mental retardation, pharmacotherapy and calcium supplementation, and demographic characteristics. RESULTS: The prevalence of low BMD in this study group was 78.8% (n=189), with 157 (65.1%) participants in the osteoporosis range and 32 (13.3%) in the osteopenia range. The average age was 45.8 years, with residents ranging from 20 to 91 years; 67.6% (n=163) were male. Nearly three-fourths of participants were in either the severe or profound range of mental retardation. Forty residents received multiple medications, contributing to bone loss. The incidence of documented nontraumatic fractures was 3.5%. CONCLUSIONS: Low BMD is prevalent in mentally retarded and developmentally disabled residents in intermediate care settings with low mobility and other risk factors. Consultant pharmacists have the opportunity to suggest appropriate pharmacotherapy for the treatment of low BMD in this setting.

Journal Article↗

PubMed1997

Technical elements, demonstration projects, and fiscal models in Medicaid managed care for people with developmental disabilities.

We presented a general model of the structure and functioning of managed care and described elements (provider networks, fiscal elements, risk estimation, case-mix, management information systems, practice parameters, and quality improvement) critical to service delivery for people with developmental disabilities. A number of technical elements of managed care systems were delineated and reviewed in relation to the inclusion of people with developmental disabilities. Several managed care demonstration projects were described and, finally, a multi-year hypothetical budget model, including long-term care, was presented as a framework for considering how managed care affects specific service structures. Implications for people with developmental disabilities were discussed.

Developmental Disabilities↗

PubMed1997

Prognosis for survival and improvement in function in children with severe developmental disabilities.

OBJECTIVE: To derive prognostic data for survival and clinical improvement in children with severe developmental disabilities. STUDY DESIGN: A 13-year follow-up study of several cohorts of children initially evaluated before their first birthday. The outcomes studied were survival and improvement in condition. Methods were used to overcome limitations in previously published work on the same California data base. Of the 11,912 children who received services from the California Department of Developmental Services between January 1980 and December 1993, we focused on three cohorts defined according to mobility and need for tube feeding. RESULTS: Children who were tube fed and unable to lift their heads by ages 3 to 12 months were at high risk for early death, with a median remaining life expectancy of 3.2 years. Of those who survived an additional 2 years, the condition of about one third improved. A substantial majority of those who either showed improvement or died had done so by that age. CONCLUSION: By age 5 years, the prognoses for survival and improvement have to a large extent been clarified. For children who survive to age 5 years, even those in the lowest functioning cohort have a 60% chance of surviving an additional 5 years. Detailing the probabilities of various outcomes at various ages should be useful to parents, pediatricians, and others concerned with children with developmental disabilities.

Age Distribution↗

PubMed2002

Co-occurrence of developmental disabilities with birth defects.

This article begins with a discussion of the concepts of comorbidity and co-occurrence of diseases and health conditions. These concepts are then applied to the literature on the population-based prevalence of developmental disabilities and birth defects. Most of the existing literature focuses on co-occurrence and obtains data from both clinical and administrative sources. Developmental disabilities occur more frequently in children with multiple, rather than with isolated, birth defects. More research, with more sophisticated study designs, will be necessary to further elucidate the contributions of birth defects to the etiology of developmental disabilities, control for other risk factors, and to identify strategies for prevention and intervention services.

Adolescent↗

PubMedDate not supplied

Graduate nursing education: developmental disabilities and special health care needs.

As children and adults with developmental disabilities and special health care needs are integrated into home, school, and community life, nurses are being required to provide leadership, advocacy, and training in community settings to a much greater extent than in the past. To assess the school and community need for formal graduate preparation for nurses who work with individuals with developmental disabilities and/or special health care needs, 25 nurses in leadership positions representing urban and rural health agencies throughout Minnesota took part in a 5-hour focus group discussion. Analysis of data summarized from this process shows five features of the recommended curriculum necessary for advanced practitioners in this specialty area: (a) discipline-specific core competencies, (b) discipline-specific specialty competencies, (c) genetic competencies not specific to nursing but necessary to function in nursing roles, (d) interdisciplinary and intradisciplinary learning experiences, and (e) clinical experiences with preceptors. The authors recommend the development of interdisciplinary graduate programs designed to prepare nurses to assume leadership roles in school health, public health, home health care, and systems management that will affect public policy and, ultimately, promote change in the systems charged with responsibility to serve this population.

Adult↗

PubMed1989

Developing an AIDS prevention education program for persons with developmental disabilities.

The AIDS epidemic poses a serious threat to people with developmental disabilities, the magnitude of which has not yet been fully realized by many professionals working with this population. Models for effective AIDS prevention education have been developed, however, within other populations. Key principles utilized in existing models were discussed and recommendations presented on how to adapt these models when designing programs for people who have developmental disabilities, most specifically, those in the mild/moderate range of mental retardation.

Acquired Immunodeficiency Syndrome↗

PubMed2004

Patterns of service utilization by adults with a developmental disability: type of service makes a difference.

Patterns and correlates of service utilization by adults with a developmental disability were examined using data from 831 mothers of an adult child with a developmental disability. A modified Andersen model of health services was used to examine service utilization in seven domains. Multinomial logistic regression revealed that predictors of services received as well as predictors of unmet need for services varied by service. Findings emphasize the importance of considering predisposing characteristics, enabling resources, and need as well as service in order to understand patterns of service utilization.

Adult↗

PubMed1993

Parental attitudes to out-of-home placement of young children with developmental disabilities.

The study tested the research construct that parental inclination to apply for out-of-home placement for their young children with developmental disabilities (up to 5 years) was a function of their stress levels, sense of coherence, and social support received from formal and informal resources. Sixty-one parents (out of 80) of children diagnosed as developmentally disabled in the central western part of Israel participated in the study. The construct above was confirmed, as the sense of coherence and informal social support moderated the levels of stress and parental consideration of out-of-home placement for the young child. In brief, parents that favoured raising their developmentally disabled children at home had high levels of sense of coherence and a strong informal support system. Findings are interpreted with respect to practice and previous research.

Adult↗

PubMed1992

A survey of the vision assessment of the developmentally disabled and multi-handicapped in University Affiliated Programs (UAPs).

In 1989 we conducted a survey to assess the availability of vision assessments (screening and complete eye/vision examinations) in University Affiliated Programs for Persons with Developmental Disabilities (UAPs). Analysis of the results suggests that although the UAPs are continuing to provide some services for eye/vision care, only 58 percent of these centers have facilities for the screening of vision problems. Ninety-six percent of the respondents, however, feel that vision screening is important. The developmentally disabled and multi-handicapped child is at high risk for vision/eye problems. Unless this difference between service availability and the perceived importance of vision services is addressed, there is an increased risk that the child may not reach his/her full potential. The UAPs need to increase the availability of eye/vision care within the UAPs and to expand training to providers in the community to deal with the developmentally disabled and multi-handicapped.

Child↗

PubMed2003

Melatonin supplementation for severe and intractable sleep disturbance in young people with genetically determined developmental disabilities: short review and commentary.

Serious childhood developmental disabilities are common, and are debilitating for the individual and their family. Increasingly these are being shown to have genetic bases. Associated challenging behaviours are frequent, one of the commonest being severe and intractable sleep disturbance. This is associated with daytime behaviour problems, poor developmental and academic progress, and substantial familial psychopathology. Social and behavioural approaches ("sleep hygiene" measures) have, to an extent, revolutionised management; however, many individuals remain unresponsive. Modern medications therefore play increasingly important complementary roles in conjunction with psychological, educational, and social strategies. This paper reviews evidence for the frequency and severity of sleep disturbance in children and young people with severe intractable neurodevelopmental disabilities. The potential benefits of judicious and carefully monitored use of medication are described, with a focus on the importance of melatonin as a sleep inducer. It is concluded that melatonin is a potentially useful and safe adjunct to psychological and social approaches for severe sleep disturbance in this client group.

Child↗

PubMed2005

Occupational therapy using a sensory integrative approach for children with developmental disabilities.

This article provides an introduction and overview of sensory integration theory as it is used in occupational therapy practice for children with developmental disabilities. This review of the theoretical tenets of the theory, its historical foundations, and early research provides the reader with a basis for exploring current uses and applications. The key principles of the sensory integrative approach, including concepts such as "the just right challenge" and "the adaptive response" as conceptualized by A. Jean Ayres, the theory's founder, are presented to familiarize the reader with the approach. The state of research in this area is presented, including studies underway to further delineate the subtypes of sensory integrative dysfunction, the neurobiological mechanisms of poor sensory processing, advances in theory development, and the development of a fidelity measure for use in intervention studies. Finally, this article reviews the current state of the evidence to support this approach and suggests that consensual knowledge and empirical research are needed to further elucidate the theory and its utility for a variety of children with developmental disabilities. This is especially critical given the public pressure by parents of children with autism and other developmental disabilities to obtain services and who have anecdotally noted the utility of sensory integration therapy for helping their children function more independently. Key limiting factors to research include lack of funding, paucity of doctorate trained clinicians and researchers in occupational therapy, and the inherent heterogeneity of the population of children affected by sensory integrative dysfunction. A call to action for occupational therapy researchers, funding agencies, and other professions is made to support ongoing efforts and to develop initiatives that will lead to better diagnoses and effective intervention for sensory integrative dysfunction, which will improve the lives of children and their families.

Child↗

PubMedDate not supplied

Authors' institutional affiliations in Australian intellectual and developmental disabilities journals: a comparison of two decades.

The generation of new knowledge through research can contribute significantly to the improvement of services for individuals with intellectual and developmental disabilities. This study extends a previous study by Sigafoos, Roberts, and Couzens [Aust. N.Z. J. Dev. Disabil. 17 (1991) 331] by examining research productivity in intellectual and developmental disability in Australian journals for 1990-1999. Institutions that published research articles on intellectual and developmental disabilities in Australian journals in the 1990s were identified by noting the affiliations of authors. The most productive institutions were primarily universities in Australia and the United States of America. Publication trends in the decade of the 1990s are compared with trends of the previous decade (1980-1990).

Australia↗